Girls have ADHD too

Come and have a look at my daughter’s bedroom, Ann Klein* says. “And her head is just as untidy!” Clothing is strewn around the room – on the bed, under the bed and all over the floor. “She calls it organised chaos,” says Ann (43), a Cape Town-based hairstylist. “She loves books and wanted to become a librarian at one stage,” she adds, indicating the books piled up around the room.

Ann says that when she herself was at school the kids in the special-needs class were called “donkeys”. “I escaped that fate because I memorised my schoolwork like a parrot.” Ann was only recently informed by a doctor that she had a case of undiagnosed ADHD.

Fortunately Ros was referred to a psychologist when she was five and diagnosed soon afterwards.

Girls harder to diagnose

A school photograph pasted inside Ros’ cupboard shows she’s the only girl among rows of boys. Throughout her school career there were rarely more than two or three girls in her class.

This corresponds with statistics that show the ratio at which boys and girls are diagnosed with ADHD is 3:1. But it doesn’t mean the condition affects mainly boys: experts say for various reasons it’s just more difficult to diagnose girls. That’s why they often get appropriate treatment only as adults, after decades of wasted opportunities.

Many women are in their late thirties or early forties when they’re first diagnosed with ADHD, writes Kathleen Nadeau, an American psychologist who specialises in ADHD in women. “One of the most common pathways to a woman being diagnosed is when one of her children is diagnosed,” Nadeau explains. She calls it the “mommy factor”, which is what happened in Ann’s case.

The tragedy is that women diagnosed later in life often underachieve and suffer depression or anxiety, which causes them to experience more failure.

Girls who aren’t diagnosed early enough can struggle with impulse control during adolescence, Cape Town child psychiatrist Dr Lesley Carew explains. Poor impulse control in adolescence can lead to increased risk-taking behaviours such as substance abuse, reckless driving and irresponsible sexual behaviours, resulting in unplanned pregnancies and STDs, Dr Carew warns in an article in medical journal ADHD In Focus. “These behaviours can have long-term consequences for the physical and mental health of girls with ADHD.”

Girls are often overlooked for the simple reason that they’re taught to be more placid, says Helena Bester, a Cape Town remedial consultant and neurotherapist.

“Another factor is that there are more girls with a less common form of ADHD. People with ADHD can roughly be divided into three categories: the hyperactives, the fidgeters and the dreamers. Dreamers often look as if they’re concentrating but they usually aren’t taking in anything the teacher’s saying,” Bester says.